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Qleave
Notification and Payment Confirmation This form is issued in accordance with the Building and Construction Industry (Portable Long Service Leave) Act 1991 s77(2). Form BCI 14v0. BUILDING AND CONSTRUCTION WORK DETAILS QLeave levy number: S347031 Date notified: Building and construction work description: DWELLING - LOWSET & HIGHSET Lot no.: 5 Plan no.: SP 298783 Building and construction work address: 2A STARBOARD AVE Suburb: NOOSAVILLE Postcode: 4566 Internal job reference number (if applicable): [TODO] Total cost of work (GST exclusive): $2,018,073 Exempted cost of work (GST exclusive): $0.00 Total levy paid: $11,604.00 Start date: 01 Aug 2023 Finish date: 01 Jul 2024 Council: NOOSA SHIRE COUNCIL Certifier: CODES BUILDING CERTIFICATION Owner: JACOBINA CORINA KIERS Principal contractor: THE TRUSTEE FOR FOR THE WATHERSTON TRUST QLeave has issued this form to confirm that notification and payment has been received. Under s.77 of the Building and Construction Industry (Portable Long Service Leave) Act 1991, all obligations have been met. Your Assessment Manager (Local Government or Private Certifier - Class A) will require a copy of this form prior to the issue of a development/building permit. CONTACT QLEAVE Unit 1 62 Crockford St, Northgate Q 4013 | PO Box 315, Virginia BC Q 4014 Freecall 1800 803 481 | Email [email protected] | Web www.qleave.qld.gov.au BUILDING AND CONSTRUCTION WORK COMPLETED When your building and construction work reaches practical completion, we invite you to submit your final costs and completion date to QLeave. To provide QLeave with these details please complete the building and construction work completed form available at www.qleave.qld.gov.au and send it to [email protected] PAID Receipt number Date paid Amount paid 35693130305 31 Jul 2023 6:33:44 AM $11,604.00
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Payer details Entity type Entity type Registered company / partnership Payer details Australian Business Number * 14 762 435 284 Entity name The Trustee for FOR THE WATHERSTON TRUST Business trading name Entity Description Discretionary Trading Trust Contact details Contact person * NIGEL WATHERSTON Contact person phone number (including area code) * 0409611398 Contact person e-mail address [email protected] Postal address Address line 1 * PO BOX 111 Address line 2 Suburb * State * Postcode * WOOMBYE QLD 4559 Building and construction work details
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Building and construction work details
Description of work
DWELLING - LOWSET & HIGHSET
Type of work *
HOUSING
Estimated start date * Estimated finish date *
01 Aug 2023 01 Jul 2024
Project owner
Select if project owner details are the same as payer details
Project owner *
JACOBINA CORINA KIERS
Contact person
CORINA KIERS
Contact phone number
0415518424
Contact email address
[email protected]
Building and construction work address
Lot number Plan number
5 SP 298783
Local council *
NOOSA SHIRE COUNCIL
Building and construction work address line 1 *
2A STARBOARD AVE
Suburb * State * Postcode *
NOOSAVILLE QLD 4566
Assessment manager (building certifier - private or local council)
Has an assessment manager (building certifier - private or local council) been appointed? *
Yes No
Name *
CODES BUILDING CERTIFICATION
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Principal contractor details
Has a principal contractor been appointed? *
If a Principal Contractor has been appointed it is a requirement under the Work Health and Safety Regulation 2011 s(293) to advise who the
Principal Contractor is.
For more information please visit www.worksafe.qld.gov.au - Principal Contractors.
Yes No
Select if the principal contractor details are the same as the payer details.
Cost of work
Cost of work
Total cost of work in dollars and cents (excluding GST) *
Whole dollars *
$2,018,073
Exemption category
Leviable cost of work
$2,018,073
Amount payable
Portable Long Service Leave Levy
$7,063.34
Construction Skills Queensland Levy
$2,018.07
Work Health and Safety Levy
$2,522.59
Total levy payable
$11,604.00
Process submission
Declaration
• I certify that the information provided is true, correct and complete to the best of my knowledge and belief, knowing it is an offence to
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provide false or misleading information.*
• I agree that this declaration is to be used within the meaning of the Electronics Transactions (Queensland) Act 2001 as an electronic
communication containing my signature for the purpose of that Act.*
Amount due
$11,604
Please select a payment option *
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Credit/Debit Card
notification and payment will be issued immediately upon payment.The following cards are
accepted:
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